Florida Senate - 2021                                     SB 634
       
       
        
       By Senator Gibson
       
       
       
       
       
       6-00395-21                                             2021634__
    1                        A bill to be entitled                      
    2         An act relating to dementia-related staff training;
    3         providing a short title; creating s. 430.5025, F.S.;
    4         defining terms; requiring certain entities, as a
    5         condition of licensure, to provide specified dementia
    6         related training for new employees within a specified
    7         timeframe; requiring certain employees to receive
    8         additional dementia-related training under certain
    9         circumstances within a specified timeframe; providing
   10         requirements for the training; requiring annual
   11         dementia-related training for certain employees;
   12         requiring certain employees to receive additional
   13         training developed or approved by the Department of
   14         Elderly Affairs under certain circumstances; providing
   15         that such additional training counts toward a
   16         certified nursing assistant’s total annual training;
   17         authorizing certain health care practitioners to count
   18         certain continuing education hours toward the
   19         dementia-related training requirements under certain
   20         circumstances; requiring the department to approve
   21         such continuing education hours to satisfy the
   22         dementia-related training requirements; authorizing
   23         the department to develop a curriculum for the
   24         dementia-related training requirements and to review
   25         the curriculum at least every 4 years for a specified
   26         purpose; encouraging the department to consult with
   27         certain nationally recognized organizations; providing
   28         requirements for the curriculum; requiring the
   29         department or its designee to approve courses used to
   30         satisfy the dementia-related training requirements;
   31         requiring such courses to be approved in various
   32         formats; requiring the department or its designee to
   33         develop a registration process for training providers;
   34         providing requirements for such registration;
   35         requiring the department or its designee to issue
   36         unique identifiers to approved training providers;
   37         requiring the department or its designee to develop
   38         certain assessments and passing scores for a specified
   39         purpose; requiring certain employees to take and pass
   40         such assessments upon completion of the training;
   41         requiring training providers to issue such employees a
   42         certificate upon completing the training and passing
   43         the assessments; providing requirements for the
   44         certificate; providing that certain employees do not
   45         need to repeat certain training when changing
   46         employment, under certain circumstances; requiring the
   47         department to adopt rules; amending ss. 400.1755,
   48         400.4785, 400.6045, 429.178, 429.52, and 429.917,
   49         F.S.; revising dementia-related staff training
   50         requirements for nursing homes, home health agencies,
   51         hospices, facilities that provide special care for
   52         persons with Alzheimer’s disease or related disorders,
   53         assisted living facilities, and adult day care
   54         centers, respectively, to conform to changes made by
   55         the act; providing an effective date.
   56          
   57  Be It Enacted by the Legislature of the State of Florida:
   58  
   59         Section 1. This act may be cited as the “Florida
   60  Alzheimer’s Disease and Dementia Training Act.”
   61         Section 2. Section 430.5025, Florida Statutes, is created
   62  to read:
   63         430.5025Care for persons with Alzheimer’s disease or a
   64  related disorder; staff training.—
   65         (1)As used in this section, the term:
   66         (a)“Department” means the Department of Elderly Affairs.
   67         (b)“Direct care worker” means an individual who, as part
   68  of his or her employment duties, provides or has access to
   69  provide direct contact assistance with personal care or
   70  activities of daily living to clients, patients, or residents of
   71  any facility licensed under part II, part III, or part IV of
   72  chapter 400 or part I or part III of chapter 429.
   73         (c)“Employee” means any staff member who has regular
   74  contact or incidental contact on a recurring basis with clients,
   75  patients, or residents of a facility licensed under part II,
   76  part III, or part IV of chapter 400 or part I or part III of
   77  chapter 429. The term includes, but is not limited to, direct
   78  care workers; staff responsible for housekeeping, the front
   79  desk, maintenance, and other administrative functions; and any
   80  other individuals who may have regular contact or incidental
   81  contact on a recurring basis with clients, patients, or
   82  residents.
   83         (d)“Licensee” means a person or an entity licensed under
   84  part II, part III, or part IV of chapter 400 or part I or part
   85  III of chapter 429.
   86         (2)As a condition of licensure, licensees must provide to
   87  each of their employees, within 30 days after their employment
   88  begins, 1 hour of dementia-related training, which must include
   89  methods for interacting with persons with Alzheimer’s disease or
   90  a related disorder and for identifying warning signs of
   91  dementia.
   92         (3)In addition to the training requirements of subsection
   93  (2), licensees must require all employees who are direct care
   94  workers to receive at least 3 hours of training if the direct
   95  care workers are expected to, or their responsibilities require
   96  them to, have direct contact with clients, patients, or
   97  residents with Alzheimer’s disease or a related disorder or with
   98  populations that are at a greater risk for Alzheimer’s disease
   99  or a related disorder. The training must be completed within the
  100  first 3 months after employment begins and must include, but
  101  need not be limited to, an overview of Alzheimer’s disease and
  102  related disorders and person-centered care, assessment and care
  103  planning, activities of daily living, and dementia-related
  104  behaviors and communication for clients, patients, and residents
  105  with Alzheimer’s disease or a related disorder. Each calendar
  106  year thereafter, the licensee must require all of its direct
  107  care workers to receive at least 4 hours of continuing
  108  education, approved by the department, on these topics and any
  109  related changes in state or federal law.
  110         (4)If a licensee advertises that it provides special care
  111  for individuals with Alzheimer’s disease or a related disorder
  112  which includes direct care to such individuals, the licensee
  113  must require its direct care workers to complete 4 hours of
  114  training developed or approved by the department. This training
  115  is in addition to the training requirements of subsections (2)
  116  and (3) and must be completed within 3 months after employment
  117  begins.
  118         (5) Completion of the 4 hours of training developed or
  119  approved by the department under subsection (4) shall count
  120  toward a certified nursing assistant’s annual training
  121  requirements.
  122         (6)If a health care practitioner as defined in s. 456.001
  123  completes continuing education hours as required by that
  124  practitioner’s licensing board, he or she may count those
  125  continuing education hours toward satisfaction of the training
  126  requirements of subsections (3) and (4) if the course curriculum
  127  covers the topics required under those subsections. The
  128  department must approve such continuing education hours for
  129  purposes of satisfying the training requirements of subsections
  130  (3) and (4).
  131         (7)(a)The department may develop an evidence-based
  132  curriculum for the training requirements of this section and
  133  review the curriculum at least every 4 years to make any
  134  necessary revisions based on current research and best
  135  practices. The department is encouraged to consult with a
  136  nationally recognized organization that has expertise in the
  137  care of individuals with Alzheimer’s disease or a related
  138  disorder to develop the curriculum. The curriculum must include,
  139  at a minimum, all of the following topics related to clients,
  140  patients, and residents with Alzheimer’s disease or a related
  141  disorder:
  142         1.An overview of Alzheimer’s disease and related
  143  disorders.
  144         2.Person-centered care.
  145         3.Assessment care and planning.
  146         4.Activities of daily living.
  147         5.Dementia-related behaviors and communication.
  148         (b)The department or its designee shall approve the
  149  courses that licensees may use to satisfy the training
  150  requirements under this section. The department or its designee
  151  must approve training offered in a variety of formats,
  152  including, but not limited to, Internet-based training, videos,
  153  teleconferencing, and classroom instruction.
  154         (8)The department or its designee shall develop a process
  155  for registering training providers and maintain a list of those
  156  providers approved to provide training required under this
  157  section. To be approved, a training provider must have at least
  158  2 years of experience related to Alzheimer’s disease or related
  159  disorders, gerontology, health care, or a related field. The
  160  department or its designee shall issue each approved training
  161  provider a unique registration identifier.
  162         (9)For each training topic required under this section,
  163  the department or its designee shall develop an assessment that
  164  measures an individual’s understanding of the topic and indicate
  165  a minimum required score to pass the assessment. Upon completion
  166  of any training under this section, the employee or direct care
  167  worker must pass the related assessment. If an employee or a
  168  direct care worker completes a training and passes the related
  169  assessment, the training provider must issue the employee or
  170  direct care worker a certificate that includes the training
  171  provider’s name and unique identifier, the topic covered in the
  172  training, the date of completion, and the signature of the
  173  training provider. The certificate is evidence of completion of
  174  the training and assessment in the identified topic, and the
  175  employee or direct care worker is not required to repeat
  176  training in that topic if he or she changes employment to a
  177  different licensee, but he or she must comply with any
  178  applicable continuing education requirements under this section.
  179         (10)The department shall adopt rules to implement this
  180  section.
  181         Section 3. Section 400.1755, Florida Statutes, is amended
  182  to read:
  183         400.1755 Care for persons with Alzheimer’s disease or
  184  related disorders; staff training requirements.—
  185         (1) As a condition of licensure, facilities licensed under
  186  this part must provide to each of their employees training as
  187  required in s. 430.5025, upon beginning employment, basic
  188  written information about interacting with persons with
  189  Alzheimer’s disease or a related disorder.
  190         (2) All employees who are expected to, or whose
  191  responsibilities require them to, have direct contact with
  192  residents with Alzheimer’s disease or a related disorder must,
  193  in addition to being provided the information required in
  194  subsection (1), also have an initial training of at least 1 hour
  195  completed in the first 3 months after beginning employment. This
  196  training must include, but is not limited to, an overview of
  197  dementias and must provide basic skills in communicating with
  198  persons with dementia.
  199         (3) An individual who provides direct care shall be
  200  considered a direct caregiver and must complete the required
  201  initial training and an additional 3 hours of training within 9
  202  months after beginning employment. This training shall include,
  203  but is not limited to, managing problem behaviors, promoting the
  204  resident’s independence in activities of daily living, and
  205  skills in working with families and caregivers.
  206         (a) The required 4 hours of training for certified nursing
  207  assistants are part of the total hours of training required
  208  annually.
  209         (b) For a health care practitioner as defined in s.
  210  456.001, continuing education hours taken as required by that
  211  practitioner’s licensing board shall be counted toward this
  212  total of 4 hours.
  213         (4) For an employee who is a licensed health care
  214  practitioner as defined in s. 456.001, training that is
  215  sanctioned by that practitioner’s licensing board shall be
  216  considered to be approved by the Department of Elderly Affairs.
  217         (5) The Department of Elderly Affairs or its designee must
  218  approve the initial and continuing training provided in the
  219  facilities. The department must approve training offered in a
  220  variety of formats, including, but not limited to, Internet
  221  based training, videos, teleconferencing, and classroom
  222  instruction. The department shall keep a list of current
  223  providers who are approved to provide initial and continuing
  224  training. The department shall adopt rules to establish
  225  standards for the trainers and the training required in this
  226  section.
  227         (6) Upon completing any training listed in this section,
  228  the employee or direct caregiver shall be issued a certificate
  229  that includes the name of the training provider, the topic
  230  covered, and the date and signature of the training provider.
  231  The certificate is evidence of completion of training in the
  232  identified topic, and the employee or direct caregiver is not
  233  required to repeat training in that topic if the employee or
  234  direct caregiver changes employment to a different facility or
  235  to an assisted living facility, home health agency, adult day
  236  care center, or adult family-care home. The direct caregiver
  237  must comply with other applicable continuing education
  238  requirements.
  239         Section 4. Section 400.4785, Florida Statutes, is amended
  240  to read:
  241         400.4785 Patients with Alzheimer’s disease or other related
  242  disorders; staff training requirements; certain disclosures.—
  243         (1) A home health agency must provide the following staff
  244  training as required in s. 430.5025:
  245         (a) Upon beginning employment with the agency, each
  246  employee must receive basic written information about
  247  interacting with participants who have Alzheimer’s disease or
  248  dementia-related disorders.
  249         (b) In addition to the information provided under paragraph
  250  (a), newly hired home health agency personnel who will be
  251  providing direct care to patients must complete 2 hours of
  252  training in Alzheimer’s disease and dementia-related disorders
  253  within 9 months after beginning employment with the agency. This
  254  training must include, but is not limited to, an overview of
  255  dementia, a demonstration of basic skills in communicating with
  256  persons who have dementia, the management of problem behaviors,
  257  information about promoting the client’s independence in
  258  activities of daily living, and instruction in skills for
  259  working with families and caregivers.
  260         (c) For certified nursing assistants, the required 2 hours
  261  of training shall be part of the total hours of training
  262  required annually.
  263         (d) For a health care practitioner as defined in s.
  264  456.001, continuing education hours taken as required by that
  265  practitioner’s licensing board shall be counted toward the total
  266  of 2 hours.
  267         (e) For an employee who is a licensed health care
  268  practitioner as defined in s. 456.001, training that is
  269  sanctioned by that practitioner’s licensing board shall be
  270  considered to be approved by the Department of Elderly Affairs.
  271         (f) The Department of Elderly Affairs, or its designee,
  272  must approve the required training. The department must consider
  273  for approval training offered in a variety of formats. The
  274  department shall keep a list of current providers who are
  275  approved to provide the 2-hour training. The department shall
  276  adopt rules to establish standards for the employees who are
  277  subject to this training, for the trainers, and for the training
  278  required in this section.
  279         (g) Upon completing the training listed in this section,
  280  the employee shall be issued a certificate that states that the
  281  training mandated under this section has been received. The
  282  certificate shall be dated and signed by the training provider.
  283  The certificate is evidence of completion of this training, and
  284  the employee is not required to repeat this training if the
  285  employee changes employment to a different home health agency.
  286         (2)(h) A licensed home health agency whose unduplicated
  287  census during the most recent calendar year was composed
  288  comprised of at least 90 percent of individuals aged 21 years or
  289  younger at the date of admission is exempt from the training
  290  requirements in this section.
  291         (3)(2) An agency licensed under this part which claims that
  292  it provides special care for persons who have Alzheimer’s
  293  disease or other related disorders must disclose in its
  294  advertisements or in a separate document those services that
  295  distinguish the care as being especially applicable to, or
  296  suitable for, such persons. The agency must give a copy of all
  297  such advertisements or a copy of the document to each person who
  298  requests information about the agency and must maintain a copy
  299  of all such advertisements and documents in its records. The
  300  Agency for Health Care Administration shall examine all such
  301  advertisements and documents in the agency’s records as part of
  302  the license renewal procedure.
  303         Section 5. Subsection (1) of section 400.6045, Florida
  304  Statutes, is amended to read:
  305         400.6045 Patients with Alzheimer’s disease or other related
  306  disorders; staff training requirements; certain disclosures.—
  307         (1) A hospice licensed under this part must provide the
  308  following staff training as required in s. 430.5025:
  309         (a) Upon beginning employment with the agency, each
  310  employee must receive basic written information about
  311  interacting with persons who have Alzheimer’s disease or
  312  dementia-related disorders.
  313         (b) In addition to the information provided under paragraph
  314  (a), employees who are expected to, or whose responsibilities
  315  require them to, have direct contact with participants who have
  316  Alzheimer’s disease or dementia-related disorders must complete
  317  initial training of at least 1 hour within the first 3 months
  318  after beginning employment. The training must include an
  319  overview of dementias and must provide instruction in basic
  320  skills for communicating with persons who have dementia.
  321         (c) In addition to the requirements of paragraphs (a) and
  322  (b), an employee who will be providing direct care to a
  323  participant who has Alzheimer’s disease or a dementia-related
  324  disorder must complete an additional 3 hours of training within
  325  9 months after beginning employment. This training must include,
  326  but is not limited to, the management of problem behaviors,
  327  information about promoting the patient’s independence in
  328  activities of daily living, and instruction in skills for
  329  working with families and caregivers.
  330         (d) For certified nursing assistants, the required 4 hours
  331  of training shall be part of the total hours of training
  332  required annually.
  333         (e) For a health care practitioner as defined in s.
  334  456.001, continuing education hours taken as required by that
  335  practitioner’s licensing board shall be counted toward the total
  336  of 4 hours.
  337         (f) For an employee who is a licensed health care
  338  practitioner as defined in s. 456.001, training that is
  339  sanctioned by that practitioner’s licensing board shall be
  340  considered to be approved by the Department of Elderly Affairs.
  341         (g) The Department of Elderly Affairs or its designee must
  342  approve the required 1-hour and 3-hour training provided to
  343  employees or direct caregivers under this section. The
  344  department must consider for approval training offered in a
  345  variety of formats. The department shall keep a list of current
  346  providers who are approved to provide the 1-hour and 3-hour
  347  training. The department shall adopt rules to establish
  348  standards for the employees who are subject to this training,
  349  for the trainers, and for the training required in this section.
  350         (h) Upon completing any training described in this section,
  351  the employee or direct caregiver shall be issued a certificate
  352  that includes the name of the training provider, the topic
  353  covered, and the date and signature of the training provider.
  354  The certificate is evidence of completion of training in the
  355  identified topic, and the employee or direct caregiver is not
  356  required to repeat training in that topic if the employee or
  357  direct caregiver changes employment to a different hospice or to
  358  a home health agency, assisted living facility, nursing home, or
  359  adult day care center.
  360         Section 6. Subsections (2) through (8) of section 429.178,
  361  Florida Statutes, are amended to read:
  362         429.178 Special care for persons with Alzheimer’s disease
  363  or other related disorders.—
  364         (2)(a) An individual who is employed by a facility that
  365  provides special care for residents who have Alzheimer’s disease
  366  or other related disorders, and who has regular contact with
  367  such residents, must complete the up to 4 hours of initial
  368  dementia-specific training as required in s. 430.5025 developed
  369  or approved by the department. The training must be completed
  370  within 3 months after beginning employment and satisfy the core
  371  training requirements of s. 429.52(3)(g).
  372         (b) A direct caregiver who is employed by a facility that
  373  provides special care for residents who have Alzheimer’s disease
  374  or other related disorders and provides direct care to such
  375  residents must complete the required initial training and 4
  376  additional hours of training developed or approved by the
  377  department. The training must be completed within 9 months after
  378  beginning employment and satisfy the core training requirements
  379  of s. 429.52(3)(g).
  380         (c) An individual who is employed by a facility that
  381  provides special care for residents with Alzheimer’s disease or
  382  other related disorders, but who only has incidental contact
  383  with such residents, must be given, at a minimum, general
  384  information on interacting with individuals with Alzheimer’s
  385  disease or other related disorders, within 3 months after
  386  beginning employment.
  387         (3) In addition to the training required under subsection
  388  (2), a direct caregiver must participate in a minimum of 4
  389  contact hours of continuing education each calendar year. The
  390  continuing education must include one or more topics included in
  391  the dementia-specific training developed or approved by the
  392  department, in which the caregiver has not received previous
  393  training.
  394         (4) Upon completing any training listed in subsection (2),
  395  the employee or direct caregiver shall be issued a certificate
  396  that includes the name of the training provider, the topic
  397  covered, and the date and signature of the training provider.
  398  The certificate is evidence of completion of training in the
  399  identified topic, and the employee or direct caregiver is not
  400  required to repeat training in that topic if the employee or
  401  direct caregiver changes employment to a different facility. The
  402  employee or direct caregiver must comply with other applicable
  403  continuing education requirements.
  404         (5) The department, or its designee, shall approve the
  405  initial and continuing education courses and providers.
  406         (6) The department shall keep a current list of providers
  407  who are approved to provide initial and continuing education for
  408  staff of facilities that provide special care for persons with
  409  Alzheimer’s disease or other related disorders.
  410         (3)(7) Any facility more than 90 percent of whose residents
  411  receive monthly optional supplementation payments is not
  412  required to pay for the training and education programs required
  413  under this section. A facility that has one or more such
  414  residents must shall pay a reduced fee that is proportional to
  415  the percentage of such residents in the facility. A facility
  416  that does not have any residents who receive monthly optional
  417  supplementation payments must pay a reasonable fee, as
  418  established by the department, for such training and education
  419  programs.
  420         (4)(8) The department shall adopt rules to establish
  421  standards for trainers and training and to implement this
  422  section.
  423         Section 7. Subsection (1) of section 429.52, Florida
  424  Statutes, is amended to read:
  425         429.52 Staff training and educational requirements.—
  426         (1) Each new assisted living facility employee who has not
  427  previously completed core training must attend a preservice
  428  orientation provided by the facility before interacting with
  429  residents. The preservice orientation must be at least 2 hours
  430  in duration and cover topics that help the employee provide
  431  responsible care and respond to the needs of facility residents.
  432  Upon completion, the employee and the administrator of the
  433  facility must sign a statement that the employee completed the
  434  required preservice orientation. The facility must keep the
  435  signed statement in the employee’s personnel record. Each
  436  assisted living facility shall provide staff training as
  437  required in s. 430.5025.
  438         Section 8. Subsection (1) of section 429.917, Florida
  439  Statutes, is amended to read:
  440         429.917 Patients with Alzheimer’s disease or other related
  441  disorders; staff training requirements; certain disclosures.—
  442         (1) An adult day care center licensed under this part must
  443  provide the following staff training as required in s. 430.5025:
  444         (a) Upon beginning employment with the facility, each
  445  employee must receive basic written information about
  446  interacting with participants who have Alzheimer’s disease or
  447  dementia-related disorders.
  448         (b) In addition to the information provided under paragraph
  449  (a), newly hired adult day care center personnel who are
  450  expected to, or whose responsibilities require them to, have
  451  direct contact with participants who have Alzheimer’s disease or
  452  dementia-related disorders must complete initial training of at
  453  least 1 hour within the first 3 months after beginning
  454  employment. The training must include an overview of dementias
  455  and must provide instruction in basic skills for communicating
  456  with persons who have dementia.
  457         (c) In addition to the requirements of paragraphs (a) and
  458  (b), an employee who will be providing direct care to a
  459  participant who has Alzheimer’s disease or a dementia-related
  460  disorder must complete an additional 3 hours of training within
  461  9 months after beginning employment. This training must include,
  462  but is not limited to, the management of problem behaviors,
  463  information about promoting the participant’s independence in
  464  activities of daily living, and instruction in skills for
  465  working with families and caregivers.
  466         (d) For certified nursing assistants, the required 4 hours
  467  of training shall be part of the total hours of training
  468  required annually.
  469         (e) For a health care practitioner as defined in s.
  470  456.001, continuing education hours taken as required by that
  471  practitioner’s licensing board shall be counted toward the total
  472  of 4 hours.
  473         (f) For an employee who is a licensed health care
  474  practitioner as defined in s. 456.001, training that is
  475  sanctioned by that practitioner’s licensing board shall be
  476  considered to be approved by the Department of Elderly Affairs.
  477         (g) The Department of Elderly Affairs or its designee must
  478  approve the 1-hour and 3-hour training provided to employees and
  479  direct caregivers under this section. The department must
  480  consider for approval training offered in a variety of formats.
  481  The department shall keep a list of current providers who are
  482  approved to provide the 1-hour and 3-hour training. The
  483  department shall adopt rules to establish standards for the
  484  employees who are subject to this training, for the trainers,
  485  and for the training required in this section.
  486         (h) Upon completing any training described in this section,
  487  the employee or direct caregiver shall be issued a certificate
  488  that includes the name of the training provider, the topic
  489  covered, and the date and signature of the training provider.
  490  The certificate is evidence of completion of training in the
  491  identified topic, and the employee or direct caregiver is not
  492  required to repeat training in that topic if the employee or
  493  direct caregiver changes employment to a different adult day
  494  care center or to an assisted living facility, nursing home,
  495  home health agency, or hospice. The direct caregiver must comply
  496  with other applicable continuing education requirements.
  497         (i) An employee who is hired on or after July 1, 2004, must
  498  complete the training required by this section.
  499         Section 9. This act shall take effect July 1, 2021.